Treating Brain Tumors with Gamma Knife

A doctor reviews brain scans with the older male patient
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Most people would find it hard to imagine having brain surgery and returning home that same day. However, with a form of radiosurgery called gamma knife, it happens frequently at AdventHealth Orlando, the only hospital in Central Florida with this technology. And despite the name, no blades or incisions are used during the procedure. This method, used to treat tumors of the central nervous system involving the brain and upper spine, uses hundreds of beams of gamma radiation that focus precisely on the target lesion, says Nikhil Rao, MD, radiation oncologist, where a multidisciplinary team of neurosurgeons and radiation oncologists have performed nearly 3,500 procedures since 1996. This allows accurate treatment with millimeters of precision. Here's how it's done:
  1. Typically, in the morning a special frame is placed on the patients head by the neurosurgeon. This allows for immobilization of the head and also allows for localization of the target lesions.
  2. Next, a special imaging study, including MRI scans, CT scans and angiograms, is done in order to target the lesion.
  3. The treatment takes place, then the frame is then removed.
  4. The patient goes home in the afternoon.
  5. Follow up appointments occur one to two months later.
What conditions can be treated with gamma knife radiosurgery?
  • Intracranial tumors including brain metastases, pituitary adenomas, meningiomas, acoustic neuromas, chordomas, chondrosarcomas and gliomas.
  • Vascular malformations and functional disorders such as trigeminal neuralgia.
Patients are not candidates if there is poor evidence that their lesions will respond to treatment, Dr. Rao adds. And some tumors are too large to be able to be treated with gamma knife. What are the benefits of this therapy over traditional surgery?
  • It's done in one treatment and has excellent results.
  • Many patients are able to have gamma knife and otherwise would have needed open surgery with equivalent results.
  • Its an option for lesions deep in the brain that cant be accessed by traditional surgery.
  • No incisions are made. Since gamma knife is actually a form of radiation therapy, and not surgery, no incisions are necessary and general anesthesia isn't needed.
  • Treatment lasts about two hours.
  • Most patients are back home and able to resume regular activities the same day.
Gamma knife has worldwide acceptance, outcomes have been published in more than 2500 articles and indications for its use continue to grow, says Dr. Rao.

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